Successful coil embolization of post-hepatectomy arterioportal fistula that reduced ascites and improved liver function
A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascite...
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| Published in | Radiology case reports Vol. 19; no. 6; pp. 2206 - 2210 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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01.06.2024
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| Abstract | A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascites was thought to be caused by portal hypertension due to a high-flow hepatic arterioportal fistula (HAPF). The fistula, located between the right hepatic artery A7 and the right portal vein, was embolized with microcoils under flow control using a balloon catheter. After embolization, the shunt blood flow disappeared and the hepatopetal venous flow was restored. His body weight and abdominal circumference decreased immediately, and his liver function on blood tests improved after the procedure. CT performed 11 days after embolization showed decreased ascites. A HAPF after hepatectomy is extremely rare. Balloon-assisted embolization using microcoils is a useful endovascular procedure for treating a high-flow HAPF. |
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| AbstractList | A 71-year-old man had previously undergone S7 + S8 dorsal segmentectomy and S5 partial hepatectomy for hepatocellular carcinomas. Six months later, he experienced abdominal distention. Abdominal computed tomography (CT) showed massive ascites and a significant hepatic arterioportal shunt. The ascites was thought to be caused by portal hypertension due to a high-flow hepatic arterioportal fistula (HAPF). The fistula, located between the right hepatic artery A7 and the right portal vein, was embolized with microcoils under flow control using a balloon catheter. After embolization, the shunt blood flow disappeared and the hepatopetal venous flow was restored. His body weight and abdominal circumference decreased immediately, and his liver function on blood tests improved after the procedure. CT performed 11 days after embolization showed decreased ascites. A HAPF after hepatectomy is extremely rare. Balloon-assisted embolization using microcoils is a useful endovascular procedure for treating a high-flow HAPF. |
| Author | Ueda, Shota Inagaki, Riki Sato, Hirotatsu Fukuda, Kodai Ikoma, Akira Tanaka, Ryota Kamisako, Atsufumi Higashino, Nobuyuki Minamiguchi, Hiroki Okuhira, Ryuta Sonomura, Tetsuo |
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| Cites_doi | 10.1111/j.1872-034X.2008.00341.x 10.1016/j.transproceed.2010.04.032 10.3748/wjg.v19.i17.2714 10.1097/MD.0000000000009893 10.1177/15385744231165155 10.1016/j.gassur.2005.06.022 10.1177/02841851211023995 10.3348/kjr.2014.15.2.250 10.1055/s-0042-1743112 10.1007/s003830050666 10.1186/s40792-018-0465-9 10.1186/s12876-018-0899-3 10.14218/JCTH.2021.00100 10.3748/wjg.v21.i7.2229 10.1053/gast.1997.v113.pm9322535 |
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| Keywords | Balloon catheter Embolization Hepatic arterioportal fistula Microcoil |
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| Title | Successful coil embolization of post-hepatectomy arterioportal fistula that reduced ascites and improved liver function |
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